Barely three days after admission to Al-Hikma hospital in the north-eastern Syrian city of Hasakah, Jihan took her last breath to the great astonishment of her family members.

Jihan’s husband, Yasser Mustafa, a man in his forties, could not believe the rapid deterioration in his wife’s condition: “She became sick so I took her to hospital, and on the next day doctors amputated her right foot after a gangrene infection, and then she died” he said in disbelief.

Mustafa tried to save her life by transferring her to the capital Damascus, only to find the doctors telling him “It is too late… there is no hope in saving her life.”

Jihan Mullah Ali was 33 years of age, and had previously taken up a job as a cleaner of operating rooms in the governmental National Hospital in Hasakah, in order to help her husband support their six children. For the next two years she would sterilise and clean operating rooms and doctors’ scalpels while collecting the remains (waste) of surgical operations in bags, according to her husband.

According to doctor Adel Sharif, “Jihan had Lupus, an auto-immune inflammatory disease that attacks the immune system of the body, and this was the reason for her gangrene.” Gangrene is a type of tissue death resultant from a shortage of blood supply or a serious bacterial infection. Sharif proceeds to explain that the nature of Jihan’s work and her exposure to medical waste and remains from operating rooms played a role in her infection.

The medical report on Jihan’s case reveals some further details of her condition: “Ms Jihan Mullah Ali undertook emergency surgery under general anesthesia because of gangrene in the lower-right part of her body as a result of an auto-immune condition (Lupus); she was subject to an endoscopy of her coagulated tissue in her leg and right thigh in the Al-Hikma hospital on the 29^th of October 2018, after which she died a from septic shock.”

Mohammad al-Darwish, a doctor specialising in internal disease, explains there are two main causes of Lupus: the first is genetic, the second environmental – the latter which can be spurred on by certain viruses and medications, which raises the likelihood that Jihan’s exposure to medical waste played a key role in her Lupus infection and subsequent death.

In addition to Jihan’s case, this investigation also documents the stories of five other men and women who work in hospitals and medical centres in north-east Syria, and who were infected with chronic and fatal diseases because of their unsafe exposure to medical waste.

This pattern has taken place amidst a failure by hospital cleaners to follow the preventative and safety procedures for dealing with medical waste, and in the absence of oversight and regulation from above.

Accordingly, the problem has been exacerbated by the failure of the hospitals examined in the investigation in the province of Hasakah to apply the safety procedures stipulated in the “national guide for the safe management of healthcare waste in Syria” relating to the collection, transport, storage and discharge of medical waste, which causes nurses and cleaners to handle the medical waste in the same way that they would ordinary rubbish (litter).

The investigation followed and documented the entire journey which medical waste undergoes, starting from its discharge from operating rooms to its placement in normal plastic bags, disposal in municipality garbage trucks and finally its transport to city outskirts where they are burned in a primitive fashion in random pits.

Furthermore, the detailed standards and criteria stipulated in the Syrian Health Ministry’s hospital guides (which stipulates the conditions for the establishment of hospitals before they are built) lack any mention of the need for a medical waste incinerator at the hospital.

According to Yunis Abu Zaid, who works in a medical laboratory in the city of Qamishli: “There are no warnings in public and private hospitals against the spread of certain diseases,” adding that “hospital cleaners are the most exposed to infection because they are less aware of preventative measures than doctors.”

For his part, Shirzad Yusuf, a specialist in general surgery in Qamishli, explains that infection is transmitted after a wound is contaminated by the substance present amongst the patient’s medical waste which carries the virus, adding that the infection rate in the city is high.

Unsafe exposure to medical waste

The World Health Organisation defines medical waste as “secondary products of healthcare that encompass sharp and non-sharp objects contaminated with blood, body parts, bodily tissue, chemical substances, pharmaceuticals and radioactive materials.”

WHO affirms that the poor management of health-care waste exposes healthcare workers, waste-handlers, patients and the general community to cases of infection and avoidable toxic effects and injuries.

During a few field visits to public and private hospitals especially in the province of Hasakah, researchers met with workers and doctors, all of whom affirmed the absence of medical incinerators either inside or outside these hospitals; the investigator also inspected and observed the mixing of different types of waste with each other, including sharp medical waste that causes injuries and transmits viruses.

According to Abu Zaid, “the disposal of medical equipment such as needles, scalpels, arterial catheters and laboratory glassware in a rubbish bin without abiding by the safety precautions can lead to injuries and infections being transmitted to patients,” while adding that it is necessary for every hospital to have an incinerator.

It should be noted that healthcare management in the north-eastern region of Jazira (encompassing the provinces of Raqqa, Hasakah, and Deir al-Zor east of the Euphrates) is split between the Syrian government – comprised in the Health Ministry – and the Kurdish-led ‘Autonomous Administration’, with both parties sharing authority in the aforementioned geographical expanse.

The co-president of the “Health Authority” of the Autonomous Administration in the city of Qamishli, Dr Abir Hassaf, admits the existence of a major problem because of the absence of medical waste incinerators, declaring: “The only incinerator is in the city of Derika (Al-Malikiyah), which was installed in 2018 with the aid of an international organization, and is only sufficient for the hospital in that area and the medical centres in its environment.” Hassaf adds that the price of an incinerator is $23,000 US Dollars – or more than 14 million Syrian Liras.

Hassaf justifies the absence of an incinerator by stating that the hospitals in question were built before the establishment of the Autonomous Administration, and therefore the Health Authority is not at fault for the absence of medical waste incinerators. Yet a field visit by the head of the investigation revealed that the eye and heart hospital in the city of Qamishli, managed by the Autonomous Administration’s Health Authority and which opened early on this year, also lacked a medical waste incinerator.

In February 2019, the investigation followed a municipality car collecting and transporting waste starting at Qamishli – after he received a tip that medical waste was disposed of alongside the ordinary rubbish which the car transported.

A cleaner in the ‘National Hospital’ in Hasakah told Raseef22 that medical waste, including bags of blood, empty and used syringes, body parts, soiled dressings and scalpels used in surgery were collected in specific bins placed in the hospital’s corridors, before the bins are emptied in a dumpster whose contents are then thrown in the back of municipality garbage trucks without wearing any gloves; the municipality’s cleaners than mix the medical waste with general waste inside the garbage truck. Finally, the waste is transported and incinerated.

The garbage truck’s journey ended in the ‘Nafkari’ landfill near the city of Qamishli, after having passed through several hospitals and medical centers to collect their medical waste, which is then piled up, accumulated and intermittently set on fire, so that the fire is not extinguished. Even after the combustion process was over, the investigator found the remnants of medical waste in the landfill, including catheters, vaccines and bottles of medication, amongst others.

From Cleaning the Nephrology Units to Kidney Failure

42-year old Wa’il al-Salem cleaned units at the nephrology department in al-Hasakah’s National Hospital  between the years 2015-2017. He would receive 70,000 Syrian Liras ($120 US Dollars) every month for his work in order to support his family of eight only to eventually succumb himself to kidney failure and lose his job.

“I used to clean the floors of the nephrology department in the hospital, and often collected waste without wearing medical gloves, while I sometimes wore [medical] face masks” al-Salem says.

After a period of time, Wa’il started to feel exhausted and was unable to go to work; he returned to the same hospital he worked in to undergo a medical examination, only to discover that his kidneys were failing and he additionally had high blood pressure and a calcium deficiency, according to the medical report examined by the investigator.

During the investigator’s meeting with Wa’il, he noticed that he appeared very weak and also had rashes on his skin, which meant that he had to undertake repeated dialysis sessions.

Wa’il explained that most of the rubbish which he collected as a cleaner in the nephrology department contained bags of serum, needles, soiled dressings and blood-soaked cotton.

Faisal Askar is a specialist in internal medicine; he believes that the country’s conditions following the outbreak of the Syrian war in 2011 led to a decline in health and cultural standards, and consequently to the appearance of certain septic diseases such as brucellosis, typhoid and hepatitis A, B and C – which often in turn led to patient dehydration and acute kidney failure, both in the general public and to those working in the medical field.

Askar called for the “necessity of reviewing the training of medical cadres to avoid any medical defects.

Lack of Prevention

Aisha Helal – 39 years-old – has worked as a cleaner in the emergency department in the National Hospital in Hasakah for the past three years. She earns a salary of 80,000 Liras ($150 US Dollars) monthly to support her special-needs husband and four children. However, as with others she began to suffer a severe difficulty in her breathing and a fast heart-beat during her work. She says that she has since spent 200,000 Liras on treatment.

Explaining how she contracted her illness, Helal said: “Every day I carry the bins that are filled with medical waste from the emergency department to the main rubbish containers in the hospital, and I clean the floors from medical waste and blood, needles and other things.” Helal goes on to confirm that she did not wear gloves or medical masks during her work, stating that she did not feel comfortable when doing so and never even tried it, despite their availability in the hospital.

According to Abdul Rahman Amin – Aisha’s doctor – the patient had a chronic allergy that was exacerbated when exposed to dust, cleaning substances and waste from surgical operations.”

As with the case of Aisha, most cleaners inside hospitals and medical centres do not wear precautionary gloves or masks, a reality also extending to the approximately 2,000 municipality cleaners who handle the waste outside of hospitals, according to Tariq Mohammad, who works in the Environmental Office in the Municipalities’ Committee in the Municipality of Qamishli.

These workers are often exposed to medical waste without taking any preventive or precautionary measures. The compiler of the investigation similarly found that municipality workers did not wear medical gloves designed to prevent the spread of viruses despite their availability in hospitals, and in the absence of any oversight or regulation that compels them to wear it.

We put these findings to the head of the Autonomous Administration’s Health Authority Hassaf, who responded: “Gloves are available in hospitals, and if they are not worn by cleaners then they are not following hygiene standards.” As regarding the municipality’s cleaners, Hassaf blamed the health department in the municipalities for not enforcing regulations on their workers.

No Vaccines, No Tests

Sulaiman Ahmed, a doctor in the province of Hasakah, stresses the need for workers to undergo medical tests before being accepted for work, in order to make sure that they were not infected by certain diseases, such as tuberculosis and hepatitis, noting that these are necessary tests because of their contagious nature which can be transmitted through blood or breathing.

As for the post-recruitment stage and how to deal with medical waste once inside work, Ahmad states that the workers are obligated to undertake a periodic test to check for communicable diseases, not least because of the fact that medical waste is contaminated with diseases – with various diseases being transmittable through needles, syringes and scalpels, and through piercings and wounds.

Ahmed stresses that hepatitis vaccines have to be taken over several intervals, in the event that a person did not have Hepatitis B. The first vaccine dose is followed by a second after a month, a third after six months and a fourth after four years – after which it is possible to take a supplementary supportive dose.

Through its co-president Abir Hassaf, the Autonomous Administration’s Health Authority admits that it has not conducted hepatitis tests for hospital workers, attributing the reason to the absence of vaccines – with the World Health Organization only providing the Syrian government, and not the Autonomous Administration, with vaccines as the only ‘recognised’ authority in Syria.

Hassaf clarified however that an understanding has since been reached with the World Health Organization by which vaccines would be provided; however, medical tests for workers have to be conducted before the immunisation can take place, a process which Hassaf says has so far not happened, alluding to the fault of local municipalities.

The head of the investigation attempted to reach the World Health Organisation on the 16^th and 28^thof March 2019 by email, in order to further examine the case and its findings, but did not receive a response up to the publication of the investigation.

Unenforced Laws

Amongst the most prominent reasons for the establishment of hospitals without medical waste incinerators is the failure to enforce the Syrian hygiene law which obligates the acquisition of these incinerators – the absence of which have led to most hospitals in the al-Jazira region dispose of medical waste in an unsafe manner.

Accordingly, the fifth chapter of the Syrian Hygiene Law (no. 49 for the year 2004) set out the mechanism for dealing with medical waste – however, this mechanism remains unenforced in the country’s north-east.

Article 23 of the law stipulates that owners of medical facilities have to segregate the different types of medical waste (non-hazardous from hazardous), with each labelled accordingly and placed in specific rubbish containers.

Article 24 of the law meanwhile obligated those transporting medical waste to not mix it with any other rubbish, and to subject it to hygienic and safe treatment; Article 25 delineates the need to provide cooling (refrigeration) units for the medical waste in the event that they are stored for 48 hours – a requirement which the investigation showed has not been followed.

As for the means of disposal, the Syrian Health Ministry stipulated six methods, the most important of which was to burn them at high temperatures in specific medical ovens.

It should be noted that the city of Qamishli contains 10 private hospitals and one public (governmental) hospital, as well as tens of medical centres, according to a chart published by the Syrian Health Ministry.

According to a 2015 report by the Roj Centre for the Protection of the Environment, hospitals leave behind almost two tons of medical waste every week, with a small hospital of 25 beds producing approximately 10 kilograms of waste.

Environmental Damage

The negative impacts of incinerating medical waste in landfills do not only encompass workers being infected with disease, but also includes the environment through the emissions produced by the unsafe incineration of medical waste.

According to Dilibirine Mohammad, a member of the board of trustees of the local Keskayi Organisation for the Protection of the Environment: “Dumping medical waste with general rubbish leads to the altering of the composition of the waste by changing its contents – thus transforming it from normal substances to toxic substances which are hazardous to both humans and the environment.”

Mohammad explains that the primitive incineration of medical waste releases a huge quantity of pollutants, including heavy metals such as arsenic, chromium, brass, mercury and lead which accumulate in drinking water, soil, plants and animal bodies – adding that the imbibing of high concentrations of these minerals by humans has toxic effects, especially lead and arsenic.

According to a 2018 study by the World Health Organisation titled “Healthcare waste”, the unsafe burning of medical waste and inappropriate substances leads to the release of pollutants into the atmosphere and the release of ash residue, explaining that the burnt substances that include PCBs (polychlorinated biphenyls), dioxins and furans are cancerous substances which have been linked to an assortment of damaging effects to human health.

The study further illustrated that medical waste landfills can poison drinking water if they are not safely constructed, stressing the need to use modern incinerators that operate at a high temperature ranging between 850°-1100°C, and equipped with special equipment to discharge gases safely; these alone fulfill international standards on dioxin and furan emissions, with the burning of medical waste constituting one of the main sources of dioxins, according to the United States Environmental Protection Agency (EPA).

Dioxin is the common name given to a group of 75 purely toxic chemicals which form from the combustion of waste that contains chlorine or through the production of products that contain chlorine.

Ultimately, despite it being more than a year since Jihan Mullah Ali’s passing, her husband still digs up her old pictures, reminiscing on their nine-month long engagement and the beautiful days they spent together. Today, Jihan’s husband worries about the future of his x children who were deprived early on in their lives from their mother’s care, who went from being a worker who helped people to survive with their lives to a victim that lost her life as a result of their medical waste.

*This investigation was accomplished with support from (SIRAJ), and under the supervision of  Ahmed Haj Hamdo. Published on Raseef22

The post Death From Human Waste in Syria’s Hospitals: an Investigation appeared first on SIRAJ.

Mohammad Bassiki – Akhten Asaad:

ALhayat newspaper

In the road which lead to ALWAKALAT street in middle of commercial market in ALQAMSHLY city (north ,east Syria ) on the right of the road there is an huge electrical generator , working by diesel (MAZOUT) yellow color, the sound of its engine full of the air , And overshadows the voices of street vendors & owner of the commercial shops inside their shops , It emits thick black smoke ,beside it a tree ,it was Full of leaves and its shadow covers the place before year 2015,but today it became dried and waiting someone to pull it out .

SALWA ,The young girl  in third decade of age, notice since a period that there are a died doves thrown on the land, in her house’s garden, and she don’t know the reason , but she attributes it to pollution in the air and to poisons which filled the sky of the city.

These poisons make the healthy status of the young ARAS HAMO (25 year) falling back day by day , by continuing on breath a polluted air from the electrical generator in the street , even inside his house , because his family depend on electrical generator , where he suffers from (Inflammation of the pharynx and scratching), and he afraid of becoming worse ,and his doctor decided to put him “under intensive examination  for treatment ” according the medical report which related in his status, dated on :1 June 2017.

According the commission of the administration and municipalities in the city , that there are 175 central electrical power generators inside the Residential neighborhoods in the city which consumed daily between 2000 to 7000 liter diesel – gasoline , with average 25-30 liter per hour , and there are 40 thousand small generators working all the time ,”so that expose ALQAMSHLY city and al HASSKEH city to extreme pollution due to from poisonous gas ” according to ROJ environmental organization  .and the Chronic respiratory & chest diseases became follow the people due to breath of Toxic gas residues from electrical generators which work by Refined fuel in a primitive way, so that quicken of appearance and spread a deadly diseases like ” Pulmonary embolism” and  ” Pulmonary cancers”.

The Necessary solution

 Residents of QAMSHLI (300 thousand people) and since stopping provide the city with regular electrical power on 2012 they are suffering, and a chest & respiratory diseases  infect them ,due to breath polluted air with poisonous & cancer gas which emits from generators , one of it : Sulfur dioxide (SO2)and Carbon monoxide(co) Hydrogen sulfur(h2s) and according to  environment experts & doctors ,these gases are “poisonous and breakdown the respiratory system .

A local newspapers and media in ALHASSAKE said that: “Isis” organizing cut the electrical power utterly on ALQAMSHLI and ALHASSAKE in general (1.5 million people ) after it is control on the main power supply source “TISHREEN dam” which located in ALPHURATE river ,west of Aleppo city on spring 2014 , where the generators became” a compulsory solution ” ,MOUAZ ABDULKAREEM the joint chief of ALQAMSHLI municipality said “the generators is a need for us due to not availability of electrics , so we bring it to provide the doctor’s clinics – pharmacies  and hospitals in electrical power since starts the war .

There is a patient in every house

Every house in the city has a patient infected with “Bronchitis or pharyngitis or allergic asthma or Shortness of breath” according to DR.SAAD EDDIN HASSO the specialist in chest & internal diseases, and Lung function tests.

The doctor which works in the hospital since 2013 until now, record daily as per his saying “large” increasing in patients attendance’s rate which” suffer from chest diseases accompanying with symptoms of cough & shortness of breath “and in some times happening a defect in sense of smell, so the patient lose the ability of distinguish between smells.

The patient ZINAB SH (fifth decade) has already going out from one of the doctor’s clinic and said that she suffers from “allergic” disease and upon her medical report, it is starts appear on her a symptoms of cough accompanying to extreme pain in the chest, and she said my status become worse with presence of electrical generators which spread in city neighborhoods, and the doctor recommended me to stay away from it, but where I go? She asked while she is going out.

ABDULRAHMAN KHALIL, chief of environment protection association in ALHASSKE enhance in declaration published in “ALPHURATE” newspaper in its number 2349 date: 11-10-2017, that what happens from breathing people these gases in his saying “the polluted emissions  from electrical generators …contain on poisons & cancer materials harmful to human being directly “

Most diseases which occur and deadly

The death which due to from respiratory diseases is form the highest rate of death in Syria in rate 16.2 % for year 2009 ,and in year 2010 the respiratory system diseases was third of the “most occur” diseases in rate 12.5 % according to Syrian ministry of health .but after year 2011 and due to of generators the rate has been increased more ,as the doctor HUSSIEN OSMAN saying ,the specialist in nose & throat diseases ,where the cancer  infections has increased in the upper air roads between 75-100 % during the last five years in ALQAMSHLI and ALHASSKE ,and he depends in this result according 75% of his coming patients these days suffer from respiratory diseases &  Chronic sinusitis.

And according to specialist doctor MIRVAT BARAZI , that people who infect in respiratory diseases are increasing ,due to pollution spreading .and she refer to lack of the medical system to reliable accurate statistic depends on it.

The third of deadly diseases

The respiratory diseases in al QAMSHLI and ALHASSKE in general, which documented by the investigation editor in documented medical reports which belong to patients, and by doctors’ testimonies and statements of health centers, it will result if the patient continues living in polluted air ,and if he has Hereditary respiratory diseases or previous, to (COPD) (chronic – obstructive pulmonary disease ) which lead to death , that during a period between 6 – 10 years “, according to the specialist doctor ,JALAL MURAD .

One of (COPD) symptoms, is a cough accompanying with Sputum secretion, and shortness of breath, according to specialized “medical web”, and what causing it “environmental & industrial air pollution, and inflammations in different kinds, and it spreading in development countries”

MURAD said “the generators smoke is increasing and quicken appearance of chronic – obstructive pulmonary cases, because the final Tracheas of the patient are injure, where is occur exchanging between oxygen & carbon, and this incurable disease.

The doctor refer to that 20% from his patients have “Allergic ground” or as it known a Genetic allergy and previous respiratory diseases, and they are according that susceptible to chronic obstructive pulmonary disease (COPD), if they stay in this current polluted air, and this number apply on all ALQAMSHLI population in general, which the population of it increase currently on 300 thousand person.

That mean almost quarter of the city population are exposed to this deadly disease, and their life threatened now, while all population are exposed to respiratory diseases , he referred to that “no exist accurate statistics to the governorate in general or rest of the nearby areas about the number of sick people and their ages & distribution rate”.

The patient RADER MAHMOUD afraid, (23 years) which his family suffer from genetic respiratory diseases which is “Bronchial sensitivity” (his mother according to medical report in date 17 June 2017) from deteriorating his health to worse, so he suffers now from acute pain in the pharynx, and the doctor asked from him to keep away from pollution source promptly.

And the lady SAEDA MOHAMMAD, according to medical report on date 1(August) 2017 she is suffers from “Allergic pharyngitis” and the doctor asked from her to keep away from generators smoke, because her status will become worse, and she don’t know how she has infected, and she don’t have any choice except staying in these circumstances as she is saying.

With the doctor MURAD expectations ,the international health organization expects  in a study belong to her , the investigation editor has obtained a copy of it, and according a collected data from 193 states ,”the obstructive pulmonary disease (COPD) will be the main third cause of death in the world on year 2030″ .

The doctor MURAD Confirms the possibility of achieving the expectations of this study internationally and even in Syria ,because the criteria and the causes are available currently on the earth in ALHASSKE governorate in general , and was based on a healthy data to sates upon the medical reality of each country .

And for confront the disease and other respiratory diseases; the international health organization formed an alliance under a name “Global Alliance against Chronic Respiratory diseases”(GARD) and officially released on 28 March – 2006 in Chinese capital, Beijing.

The investigation editor has connected with professor, YOUSER MOHAMMAD, the coordinator of alliance (GARD) in Syrian, and he admitted in existence of chronic obstructive pulmonary disease, where his team which working in the Syrian government controlled area has examined  cases of Syrians displaced from areas of “ISIS” organization  control in east & north the country , they has came to governmental hospitals in Damascus ,and they are suffer from Waste of air pollution and has diagnosed many infected cases in the disease, and cases for women have infected in cancer of lung and they are non smoking under age of 50 years.

But the professor refused to provides any numbers of numbers of the sick people monthly or annually.

A new international study has published by “REUTERS” on 20 October 2017, is linking between the rate of death around the world and air pollution, where the pollution is related in 9 million death case on 2015.

And by a study, “most of deaths are cause from air pollution diseases like heart diseases – heart attack and lung cancer “.and the polluted of air is from different reasons from transportations – industrial production and the fire which used in heating, was the biggest cause of death which lead to 6.5 million death cases.

Lack of equipment impedes diagnosis

According to what professor MOHAMMED say:

Lack of medical equipment impedes diagnosis of chest and respiratory diseases like chronic pulmonary obstruction; on the other hand many “health centers had stopped working in areas of conflict”, at a time” the program began providing support like inhalation devices and other for some of health centers in cooperation with the Syrian ministry of health”, and while the reasons of disease sounds known, but its results anonymous on population, and the doctor (NILSE.BILLO) of World health organization says “the alliance until now didn`t search for the effects of the war on the health of respiratory system in Syria”. He considered that “air pollution and smoking cause chronic obstruction pulmonary disease (COPD)”.

He suggested on local communities in Syria, working to limit the risks of chronic respiratory system diseases, and chronic pulmonary obstruction disease and lung cancer depending on strategies to increase the usage of clean energies.

Acute shortage in the number of doctors

The Investigation editor in ALQAMISHLI has counted presence of clinics for 6 specialties chest surgery doctors, 9 doctors their specialties of ear –nose and throat and they supervise on the treatment of 300000 people and it is the number of city population according to unofficial numbers of the city’s doctors source, after the last official statistics in 2007 which mentioned the number of ALQAMISHLI population which was 88 thousand people.

ABEAR HASSAF the joint head of health commission which affiliate to self administration in ALHASSAKE (ALJAZERA territory) there is another kind of their suffering as a responsible medical commission and she says “we suffer from continuous emigration of specialist doctors and shortage of cadres, we fear on the long period of time from fetal distortions and emergence of malignant tumors”.

According to approved numbers of the world health organization and which published on the website of” the official international bank” about proportion of doctors and nurses with number of population , it shows that in Syria for the year of 2014 ,1.55 doctor per 1000 citizen, but in ALQAMISHLI and around it , it shows acute shortage of numbers of specialist doctors in chronic pectoral respiratory diseases ,where the number of doctors clinics  doesn`t exceed 15 clinics , only 10 of them are  doctors of pectoral and respiratory, they are treating  250-300 thousand citizen , according to the specialist doctor JALAL MURAD , one doctor  for treating 20 thousand patient.

The most dangerous gas

The annually report of ” ROJ “for environment protection for year 2015 is estimates the number of “diesel engines  ” which used for generating the power in ALQAMSHLI more about 100 generator which provide the houses with electric power , in working hours rate between (8-10) hours daily . Where there are more than 40 thousand generators which working by diesel & gasoline all the time.

And JANAR KHALAF, the specialist in the environment sciences is seeing that gases of “hydrogen sulfate” and Sulfur dioxide (Co2) and “Carbon monoxide”(CO) are dangerous, but the last gas is considered the most dangerous because of relating it with hemoglobin of the Blood in a high rate from link ratio the oxygen with Blood hemoglobin.

The danger includes everyone

Sulfate dioxide ,is a chemical compound has a formula so2 , is produce naturally from volcano and industrially from many of industrial possesses and from burning the Petroleum products which contain the sulfate compounds.

The municipalities & environment commission which affiliate to the self administration in ALQAMSHLI area and Aljazeera territory in general is imposes conditions to anyone wants to possess a big electrical generator in a neighborhood or street , and it is :the generator must be away from the general gardens – schools and congestion’s Places, and should be equipped with filters and exhausts for the sound ,as of saying the engineer ALAN MOHAMMAD ,the administrative man in the municipalities & environment commission .but 10 central generators from 175 distributed  generators in the city and countryside which has examined by the investigation editor and which has shown  breaching of these conditions ,which are located in central congestion markets and neighborhoods and daily passing beside it of  women & children and it is emitting from it noise and smoke and does not achieve the criteria and mentioned  conditions.

According to Mohamed, during the two years 2016-2017, teams of commission monitored two owners of central generators, after giving them warnings under the pretext of technical conditions infraction, with estimated fine 50 thousand Syrian bounds ($100).

Technical Specifications don’t require from generators owners to put their generators away from residential areas in a certain number of meters as a separative space, and leave it up to environment administration and its detection committees, to keep the distance of generators away from residential areas as much as possible, but according to some citizens this gap allow to many generators owners, to put their generators in the Center of markets and alleys. Big generators are used in residential areas and its price between 3 to 4 million Syrian bounds ($ 6000-8000-800 Ampere), we can say that 4 Ampere of electricity access to 200 houses daily and they are non-hidden generators of sound or smoke.

 Every living in ALQAMSHLY and ALHASSKE in general has to leave the generators to conserve the residents health or continue in situation as it is because the needing to electricity , but a  gleam of hope talking about it the official in environmental management ,ALAN MOHAMMAD about a coordination with power commission to follow up the maintenance of high voltage line KBA230 which  connects between the ALTABKA dam at east and ALHASSKE at west ,hoping to obtain the electrical power in natural way , And get rid of the current situation.

Doctor JALAL MURAD is saying that” the patients now don’t benefit from anything of treatment but on the contrary, their numbers are increasing, and the danger inclusive all … the pregnant women, aged people – children which they have another disease “.

This story has been made by The Syrian Investigative Reporting for Accountability Journalism (SIRAJ).

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